The World Health Organisation (WHO) declared the coronavirus outbreak a pandemic on 11 March, and it has now been officially recognised that the spread of COVID-19 is expected to affect most countries in the world. However, everyone can still change the course of this pandemic by taking timely and concrete actions. ESMO as the leading professional organisation for medical oncology, will continue to support oncology professionals as much as possible by helping them to deliver optimal care to their cancer patients in such exceptional circumstances.
ESMO is encouraging medical oncologists to work closely with their local governments and health authorities to maintain the provision of high-quality cancer services safely in their clinics and hospitals.
Ensure the continuum of care
Essential cancer services should be delivered but all steps should be taken to protect patients from infection with COVID-19. Individual risk from exposure to COVID-19 varies from patient to patient, and all risks should be balanced against the need for tumour control and discussed on a case-by-case basis with the patient.
In some oncology departments, cancer services have been prioritised according to urgency, giving high priority to patients receiving treatment for active disease while postponing follow-up visits. However, in the majority of patients, the benefit of following a well-planned and well-controlled anti-cancer treatment plan will outweigh the risk of a coronavirus infection.
Get prepared for a new routine
Resources re-allocation and restrictive safety measures to face the pandemic may impact
on daily routines in oncology. Contingency plans for the provision of cancer care in different scenarios should be timely assessed by proactively liaising with local administrators.
Some specific actions may help teams to adapt their routine clinical practice to the new scenario. Improving teleconsultation services for stable patients, especially for those on oral therapies, and re-evaluating regimen schedules to reduce the number of clinic visits during the pandemic (three or two-weekly as opposed to weekly, oral or subcutaneous alternatives as opposed to intravenous administration) should be encouraged. A “previous day” telephone triage should be recommended to identify flu-like symptoms in cancer patients so that appropriate measures can be taken.
Protect yourself to protect your patients
Medical oncologists, as well as other health workers, are currently exposed to hazards that may put them at risk of infection with COVID-19, including pathogen exposure, long working hours and psychological distress .
Adequate training on prevention and control of infection is key to make sure that all medical staff stay safe, thus ensuring safe cancer care environments for patients.
At work, the use of personal protective equipment is recommended. Strategies for splitting cancer healthcare personnel to rotate in shifts that are epidemiologically compatible with the coronavirus incubation time of 14 days may help to secure the safety and wellbeing of teams.
At home, medical oncologists are encouraged to follow basic protective measures against the new coronavirus as recommended by the WHO (e.g., clean your hands often, practice social distancing).
Reinforce support to patients
The impact of the COVID-19 pandemic on cancer patients may be high in terms of anxiety, fear and psychological distress. Information on how to adopt measures to prevent and control infection and open discussions on any change in regimen schedules or cancellation or delay of visits are key to ensure cancer patients’ wellbeing.
Telephone or web-mediated consulting should be improved to support patients remotely and meet their needs.